English
publication
Theunissen,
N.C.M., De-Ridder, D.T.D, Bensing, J.M., Rutten, G.E.H.M. (2003). Manipulation
of patient-provider interaction: discussing illness representations or action
plans concerning adherence. Patient Education and Counseling, 51(3),
239-245.
Abstract
According to Leventhal’s Self-Regulatory Model of Illness, patients
have ideas and action plans related to the management of their disease.
The aim of this study is to examine whether ideas and action plans relating
to hypertension change as a result of GP’s discussing them during
consultation, and whether these changed ideas and actions plans affect
adherence. The study employed an experimental design, highlighting three
conditions: (0) care-as-usual consultation; (1) discussing patient’s
ideas about their disorder; and (2) discussing patient’s action plans.
Ten GP trainees performed care-as-usual consultations, were subsequently
assigned to a training in either Condition 1 or 2, and performed the trained
conversations. Hundred and eight patients with hypertension were consecutively
assigned to the conditions, and completed questionnaires a week before,
immediately after the consultation, and one month later. The training
resulted in two new, feasible and different types of conversations that
managed to affect some of the patient’s ideas and action plans. It
is concluded that the study provided GPs with a tool to discuss illness
representations and actions plan of patients with hypertension. Implications
for the management of hypertension adherence in primary care are discussed.
Keywords
adherence, hypertension, self-regulation
theory, intervention, patient-physician interaction, illness representations